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J.Jpn. Surg. Soc.. 121(3): 301-305, 2020

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TOTALLY LAPAROSCOPIC COLECTOMY FOR RIGHT COLON CANCER

1) Cancer Center, Osaka Medical College Hospital, Takatsuki, Japan
2) Department of GE Surgery, Osaka Medical College, Takatsuki, Japan
3) Department of GE Surgery, Hirakata Hospital, Hirakata, Japan
4) Department of Surgery, Osaka Medical College Mishima-minami Hospital, Takatsuki, Japan

Junji Okuda1), Keitaro Tanaka2), Masashi Yamamoto2), Wataru Osumi2), Hiroki Hamamoto2), Shinsuke Masubuchi3), Masatsugu Ishii4), Kazuhisa Uchiyama2)

A laparoscopic-assisted procedure is generally performed for the surgical treatment of right colon cancer. In that procedure, bowel resection and anastomosis are performed outside the body. In totally laparoscopic colectomy with intracorporeal anastomosis, there are several concerns about bacterial and tumor contamination in the abdomen, improper resection, and unsafe anastomoses. To overcome those issues, we conduct appropriate bowel preparation and systematic procedures. As a result, totally laparoscopic colectomy with intracorporeal anastomosis allows the use of an oncological no-touch isolation technique, avoids excessive mobilization of the colon, has no limitations on the small incisional site, and results in safer anastomosis once the technique is acquired and surgeons become accustomed to performing it. This will lead to higher-quality results in terms of oncologic outcomes and minimally invasive surgery. Especially in cases in which extracorporeal anastomosis is difficult, such as in obese patients and those with dense adhesions, intracorporeal anastomosis is indispensable.

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